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1.5 Years of DBC Theme Health & Care: Interview with Nicky Hekster and Victor van der Hulst

The Dutch Blockchain Coalition (DBC) was established in 2017 as a collaboration between the government, educational institutions, and businesses, aiming to promote knowledge and usage of blockchain. Serving as a catalyst and facilitator, the DBC activates and connects the public-private network, acting as a driver for various themes. The themes of Energy & Sustainability, Security, Agriculture, Water & Food, Mobility, and Health & Care were on the agenda from the beginning.

In July 2022, Nicky Hekster was tasked with further shaping the Health & Care theme. As the DBC plans to step back as a driver of individual themes in 2024, this year-end reflection provides an opportunity to look back on the past one and a half years with Nicky and DBC manager Victor van der Hulst. Conducted by Femke from the Communication department, the interview delves into Nicky's efforts to stimulate the adoption of decentralized technology in the healthcare sector.

Nicky, why is decentralized technology important in the healthcare sector? 

Let me start by stating that healthcare in our country is generally good. However, the significant challenges we face in the coming years involve maintaining the quality, accessibility, affordability, and sustainability of healthcare. Additionally, there is a substantial shortage of personnel in the healthcare job market. To alleviate this pressure on healthcare, we are reliant on ICT and digital transformations. Electronic data plays a significant role. Consider AI or distinguishing between digitally manipulated and genuine medical data, medical images, or the identity of professionals or patients. Privacy is crucial, as is the security of patient data, trust in digital systems, and identity. Decentralized techniques provide an excellent solution, particularly due to the protection of medical data by design.

What initiatives have you taken to stimulate the adoption of decentralized technology in this sector? 

At the beginning, I immediately started with desk research regarding domestic and international developments. In my time at IBM, I had already encountered blockchain in Healthcare & Life Sciences. I quickly concluded that much had changed, with some adoption (though not yet implemented in, for example, clinical workflows), and that there were entities in the Netherlands working with decentralized technology in healthcare! I approached each of them and asked them to join my working group. This is how I gradually built the working group. For Phase 1, I managed to bring in many new partners: Triall, Life2Ledger, BlueGen, Syntho, FAIR CARE Solutions, Transmineo, OASYS NOW, HealthBlocks, The BrownPaperCompany, and ADL Software Engineering. Additionally, there were many companies and institutions that showed significant interest and had previously worked with blockchain in healthcare! Existing DBC partners (such as TNO, Sphereon, Saxion Hogeschool, Leopard Ledger/iDentry, LinkSight, KvK) were already involved in healthcare-related projects. It was a warm start! Furthermore, there had been previous DBC-initiated projects in healthcare, such as uNLock (during the pandemic), demonstrating that decentralized technology can truly make a difference. In addition to establishing the working group, I also contemplated potential use scenarios in the broader healthcare ecosystem. After completing Phase 1, we further developed and sometimes even implemented these scenarios in collaboration with various partners.

What have been the highlights for you within the theme in the past year?

Definitely the energy and intellectual capacity emanating from the working group. The aforementioned partners collaborate with many and diverse healthcare institutions; this observation was not only surprising but also a tremendous stimulus. Additionally, the DBC was a driver of a project by partners Triall and Sphereon focused on a platform for clinical studies (CIX, Clinical Information eXchange) based on decentralized technology. Furthermore, the Healthcare Institute Netherlands (ZIN) conducted the initial exploration for the realization of a Passport for self-employed individuals in Healthcare (ZZP-ers). I was inspired by what my DBC colleagues are doing in the area of the Company Passport and product passports.

What trends should we keep an eye on in healthcare next year? 

Regarding decentralized technology, I see a convergence with AI environments. This has also led to a closer collaboration with my counterpart at the Dutch AI Coalition, Pieter Jeekel. In the Netherlands, some examples of this convergence can already be found, such as the GERDA project in the Achterhoek or the Heracles project by TNO. The officially launched NICPET (National Innovation Center for Privacy-Enhancing Technologies) in November further confirms the need for decentralized technology for data protection, also in healthcare. On a European level, initiatives like EU Digital Identity, GAIA-X, and EHDS (European Health Data Space) are taking shape, with decentralized technologies playing a role. Discussions regarding decentralized technology in conjunction with transparency, ethics, laws, and regulations will only strengthen next year. I also believe that the next evolution of the Internet, web3, in which blockchain plays a crucial role, will eventually find its way into healthcare and life sciences.

Do you agree with that, Victor?

I can certainly agree with that. The world of healthcare is familiar to me, and I know it is a relatively conservative environment where innovation takes time to materialize. However, as Nicky pointed out, digitization has already made significant inroads into this sector, emphasizing the need for maximum caution with medical data. In healthcare, it's all about digital trust, digital reliability, and verifiability when healthcare institutions interact with each other or communicate with their clients or patients through digital channels. In recent years, the DBC, through appointed Theme Leads, including Nicky, has actively contributed to realizing self-sufficient collaborations within various themes. In 2024, the focus will shift more towards supporting the emerged use cases and projects in the transition to a sustainable form of operation. Working groups will also align with other national or even European initiatives, such as the Dutch AI Coalition and NICPET. I would also like to express my appreciation for Nicky's work, who has managed to achieve quite a bit in this short time. I'm confident that the fire in the working group is far from extinguished!

Victor, can you tell us more about the future of the DBC?
Even in 2024, the DBC remains the central hub where government, business, and knowledge institutions engaged in a reliable, decentralized, digital infrastructure come together—whether to conduct research and determine the strategic agenda, to develop and scale use cases together, or to exchange knowledge and experiences. In addition to the shift from themes to use cases, we are concurrently working on a new mission to achieve an inclusive, value-driven digital economy where secure, auditable, and privacy-respecting digital identities, ownership, value transfer, and governance become the norm.